Individual provider Active NPI

Amber Nicole Offutt, APRN

  • Acute Care Nurse Practitioner
  • Pine Bluff, AR
National Provider Identifier
1205588589
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
218131 Issued in AR
Practice address
1600 W 40TH Ave
Pine Bluff, AR 71603-6301
Phone
(870) 541-8767
Fax
(870) 541-8761
NPI assigned
Jan 19, 2022
Last updated
Oct 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 218131 AR Primary

Addresses

Primary practice location

1600 W 40TH Ave
Pine Bluff, AR 71603-6301

Mailing address

9030 Highway 79 S
Pine Bluff, AR 71603-1208
Phone (870) 883-0080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220428001126 AR Practitioner - Nurse Practitioner 0648667279 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Hospital Association, Inc CurrentSince Jul 1, 2024 Accepting new patients
Jefferson Hospital Association, Inc CurrentSince Jul 1, 2024 Accepting new patients
Southeast Arkansas Hospitalists, LLP CurrentSince Jun 18, 2023 Accepting new patients
Jefferson Hospital Association, Inc Current Accepting new patients
Affinity Palliative Care of Arkansas Past Accepting new patients

Locations

1600 W 40th Ave
Pine Bluff, AR 71603
Phone (870) 541-7100

1600 W 40th Ave
Ste 3SW
Pine Bluff, AR 71603
Phone (870) 541-8767

1601 W 40th Ave
Ste 301
Pine Bluff, AR 71603
Phone (870) 541-4285

1609 W 40th Ave
Ste 403
Pine Bluff, AR 71603
Phone (870) 534-4188

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1205588589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9030 HIGHWAY 79 S",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716031208",
            "telephone_number": "870-883-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 40TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036301",
            "telephone_number": "870-541-8767",
            "fax_number": "870-541-8761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFFUTT",
        "first_name": "AMBER",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "218131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

Verify at the official NPI Registry.